CMS Price Transparency Data

Group therapy session

Facility: Sunrise Hospital and Medical Center

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90853
  • Insurance Median: $29
  • Cash Discount Price: $91
  • vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a Group therapy session at Sunrise Hospital and Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 0.28x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.
Cash / Self-Pay
$91

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$103.79

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $103.79 (100%)
Cash / Self-Pay: $91 (88%)
Insurance Median: $29 (28%)
Cash: $91 (88% of Medicare)
Ins. Median: $29 (28% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $103.79 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Humana $16 - $35 15%
Amerigroup $17 - $23 16%
Health Plan Nevada $17 - $24 16%
Molina $18 - $25 17%
Silver Summit $18 - $35 17%
Community Care Health $22 21%
Molina Healthcare $22 - $23 21%
Sierra Hpn $22 21%
Ambetter / Centene $23 22%
Caresource $23 22%
Healthcare Partners Of Nv $23 - $36 22%
Aetna $24 - $81 23%
Alignment Health Plan $24 - $28 23%
Blue Cross Blue Shield $24 - $52 23%
United $24 - $54 23%
Caremore $25 - $29 24%
Hometown Health Providers $27 - $49 26%
Cigna $29 - $57 28%
Sierra $29 - $35 28%
Multiplan $31 - $36 30%
Culinary Health Fund $32 - $42 31%
Legacy Provider Network $40 39%
Corvel $42 - $44 40%
Comp-Med Workers Comp $43 41%
Olympus Medsave Usa $44 - $47 42%
Select Health $45 - $60 43%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3186 S Maryland Pkwy, Las Vegas, NV 89109
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals